Gender Relations and Reproductive Decision Making in Honduras
Speizer, Ilene S., Whittle, Lisa, Carter, Marion, International Family Planning Perspectives
CONTEXT: Gender differences influence decision making about reproductive health. Most information on reproductive health decision making in Latin America has come from women's reports of men's involvement.
METHODS: Data were collected in Honduras in 2001 through two national surveys that used independent samples of men aged 15-59 years and women aged 15-49. Bivariate and multivariate analyses were used to identify factors associated with male-centered decision-making attitudes and behaviors regarding family size and family planning use.
RESULTS: Overall, 25% of women and 28% of men said that men alone should be responsible for at least one of these reproductive decisions, and 27% of women and 21% of men said that the man in their household made one or both decisions. For women, having no children and being in a consensual union were each associated with holding male-centered decision-making attitudes; having less than a secondary education, being of medium or low socioeconomic status and living in a rural area were each associated with male-centered decision making. Among men, having less than secondary education and being in a consensual union were each associated with male-centered decision-making attitudes and behavior. Women who had ever used or were currently using modern methods were significantly less likely to hold attitudes supporting male-centered decision-making than were those who relied on traditional methods and those who had never used a modern method.
CONCLUSIONS: Programs should recognize power imbalances between genders that affect women's ability to meet their stated fertility desires. In rural areas, programs should target men, encouraging them to communicate with their wives on reproductive decisions.
International Family Planning Perspectives, 2005, 31(3):131-139
The international reproductive health community has acknowledged the importance of addressing gender disparities in sexual relations and reproductive health decision making as fundamental to improving the reproductive health and rights of both women and men. Gender-based power inequalities can contribute to poor health outcomes--for example, by hindering communication between partners about reproductive health decisions, by constraining women's access to reproductive health services, by preventing women's and men's attainment of sexual health and pleasure, and by increasing their risk of contracting HIV infection and other STIs. (1)
Gender inequality in reproductive decision making is a key element of the social context of reproductive health. Research shows that couples often disagree about the desirability of pregnancy and the use of contraceptives. (2) When this discordance occurs in a situation of male authority, men's opinions about these issues may overrule women's, even though the women often must implement the decisions made on these matters. In some cases, husbands fear that if they approve of family planning and allow their wife to use it, they will lose their role as head of the family, their wife may be unfaithful or they may lose face in their community. (3) Even when men approve of family planning in theory, they may disapprove of their partners' practicing contraception and may be unwilling to use male condoms. (4) As a result, women may sacrifice their own wishes to those of their partners--or their perception of their partners' wishes. (5) Alternatively, women may practice contraception covertly, potentially exposing themselves to financial vulnerability or emotional or physical violence if discovered. (6) Conversely, women who have some decision-making power and autonomy often are better able than other women to meet their reproductive health goals. (7)
The bargaining power between men and women in Latin America on these and other issues is undergoing transformation, in tandem with rapid social, economic and political changes in the region. …